Objective: To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT). Methods: The CBCT records of 20 subjects (9 boys, mean age: $13.97{\pm}1.17$ years; 11 girls, mean age: $13.53{\pm}2.12$ year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05. Results: The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively. Conclusions: RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.
Purpose: The purpose of this study was to evaluate the soft tissue and bone change around two adjacent implants in onestage implant surgery. Methods: Eleven subjects (7 males, 4 females) who were needed placement of 2 adjacent implants in the molar area were included. The two implants were placed with the platform at the level of the alveolar crest. The interproximal bone between the 2 implants was not covered with gingiva. After surgery, an alginate impression was taken to record the gingival shape and radiographs were taken to evaluate implant placement. Using a master cast, the gingival height was measured at baseline, 4 weeks, and 12 weeks. In the radiograph, the alveolar bone level was measured at the mesial and distal side of both implants at baseline and 12 weeks. Results: The exposed bone was covered with gingiva at both 4 and 12 weeks. Loss of alveolar bone around implants was found in all areas. The alveolar bone level in the exposed bone area did not differ from that in the non-exposed area. Conclusions: This study showed that the alveolar bone level and gingival height around 2 adjacent implants in the exposed bone area did not differ from that in unexposed bone area.
This study was performed to estimate the effect of plaque control on the progress of the repair pattern of the alveolar bone surface after bone surgery. In this experiment six mongrel dogs were used, four of them were as experimental group and others were as control. In the case of experimental group, dental floss ligature was tied over the neck of crown for permiting of plaque accumulation during one week before surgery and oral hygiene procedures were not performed. In control group, all the surgical intervention was done as same procedure with experimental except oral hygiene program. After surgery plaque was controlled during one week with using the chlorhexidine brushing. Animals were sacrificed at 1,2,4,6 weeks after osseous surgery. The results were as follows : 1. The alveolar bone defects were covered with regenerated epithelium at one week, matrix change of granulation tissue on subcutaneous area was observed, and new bone formation was initiated from the surface of the bone defects. 2. The connective tissue arrangement revealed more dense, new bone formation by osteoblasts was active at 2 weeks and proliferation of gingival epithelium and alveolar bone tissue were evident at 4 weeks, and almostly recovered to normal condition at 6 weeks. 3. In experimental group, inflammatory reaction was persistent in early stage and bone repair was delayed compared to control group. 4. In control group, matrix change of granulation tissue was initiated from one week, regeneration of gingival epithelium and maturation of subcutaneous conective tissue and new bone formation were evident at 2 weeks, so almost normal bone regeneration was observed at 4,6 weeks.
Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.
The alveolar bone remodeling is essential in tooth movement by orthodontic forces. The collagen and chondroitin sulfate are acting as an important roles in bone remodeling. This study was performed to measure out the quantity of the collagen and chondroitin sulfate in the alveolar bone of rats applied by experimental orthodontic forces. The 150 Sprague-Dawley male rats were divided into the $PGE_2$ treated group, indomethacin treated group and the normal group. A 80gm force rubber band was used as a orthodontic appliance between upper incisors and right upper 1st molar, and left side of experimental rats with no appliance was regarded as a control side. The samples of alveolar bones were obtained from pressure and tension sites in all three groups. respectively, and in control sides, too. The results were as follows. 1. The change in total collagen remains stable in both pressure and tension sites of all three groups, compared with control side by the time consuming. 2. The change in soluble collagen showed the most highest level in tension site, lowest level in pressure site of $PGE_2$ treated group in 5th. experimental day. 3. The change in chondroitin sulfate showed the most highest level in pressure site, lowest level in tension site of $PGE_2$ treated group in 5th. experimental day. 4. In indomethacin treated group, the change of soluble collagen and chondroitin sulfate showed small range of variance compared with $PGE_2$ treated and normal group.
Purpose: The present study describes 3 patients with chronic periodontitis and consequent vertical resorption of the alveolar ridge who were treated using implant-based restoration with guided bone regeneration (GBR). Methods: After extraction of a periodontally compromised tooth, vertical bone augmentation using a K-incision was performed at the healed, low-level alveolar ridge. Results: The partial-split K-incision enabled soft tissue elongation without any change in buccal vestibular depth, and provided sufficient keratinized gingival tissue during GBR. Conclusions: Within the limits of this study, the present case series demonstrated that the novel K-incision technique was effective for GBR and allowed normal implant-based restoration and maintenance of a healthy periodontal condition. However, further long-term follow-up and a large-scale randomized clinical investigation should be performed to evaluate the feasibility of this technique.
Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.
Objective: To investigate changes in the immature teeth of Sprague-Dawley rats during orthodontic treatment and to explore the changes in the peri-radicular alveolar bone through micro-computed tomography (CT). Methods: Twenty-five 26-day-old male Sprague-Dawley rats were included. The maxillary left first molar was moved mesially under a continuous force of 30 cN, and the right first molar served as the control. After orthodontic treatment for 7, 14, 21, 28, and 42 days, the root length, tooth volume, and alveolar bone mineral density (BMD) around the mesial root were measured through micro-CT. Results: The immature teeth continued to elongate after application of orthodontic force. The root length on the force side was significantly smaller than that on the control side, whereas the differences in the volume change between both sides were not statistically significant. Alveolar bone in the coronal part of the compression and tension sides showed no difference in BMD between the experimental and control groups. The BMD of the experimental group decreased from day 14 to day 42 in the apical part of the compression side and increased from day 7 to day 42 in the apical part of the tension side. The BMD of the experimental group decreased in the root apex part on day 7. Conclusions: The root length and volume of immature teeth showed continued development under orthodontic forces. Alveolar bone resorption was observed on the compression side, and bone formation was observed on the tension side.
Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.
Osteoblasts from alveolar bone may have an important role in the bone regeneration for periodontium, but their culture and characterization are not determined yet. The purpose of this study was to investigate the biological characteristics of primary explant cultured osteoblasts(PECO) from alveolar bone. Osteoblasts were isolated and cultured from alveolar socket of extracted tooth in children. To compare the characteristics, osteoblasts and gingival fibroblasts were cultured with DMEM at $37^{\circ}C$, 5% $CO_2$, l00% humidity incubator, and human fetal osteoblasts cell line(hFOB1) were cultured with DMEM at $34^{\circ}C$, 5%, $CO_2$ 100% humidity incubator. To characterize the isolated bone cells, morphologic change, cell proliferation and differentiation were measured. Morphology of PECO was small round body or cuboidal shape on inverted microscope and was similar with hFOB1. PECO became polygonal shape with stellate and had an amorphous shape at 9th passage in culture. PECO had significantly higher activity than that of gingival fibroblasts and hFOB1 in alkaline phosphatase activity. The expression of osteocalcin and bone sialoprotein in PECO was notably increased when compared with hFOB1 and gingival fibroblasts. These result indicated that PECO from alveolar bone in children has an obvious characteristics of osteoblast, maybe applied for the regeneration of bone.
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